Kanavi Mozhgan Rezaei, Hosseini Seyed Bagher, Aliakbar-Navahi Roshanak, Aghaei Hossein
Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Ocular Tissue Engineering Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Central Eye Bank of Iran, Tehran, Iran.
J Ophthalmic Vis Res. 2017 Jan-Mar;12(1):17-22. doi: 10.4103/jovr.jovr_72_16.
To report impression cytology (IC) results of clinically diagnosed ocular surface melanocytic lesions.
Ten patients with a clinical diagnosis of an ocular surface melanocytic lesion underwent IC using cellulose acetate strips and Periodic acid Schiff-Papanicolaou staining. Excisional biopsy of lesions was performed in case of observing atypical cells on IC or at the patient's request, and excised specimens were subjected to histopathological analysis. Agreement between clinical diagnoses and IC results and between IC results and histopathology were evaluated.
Clinical diagnoses were nevi in 6, primary acquired melanosis (PAM) with atypia/melanoma in 2, and atypical nevus versus pigmented conjunctival intraepithelial neoplasia (CIN) in 2 cases. IC results were suggestive of a benign nevus in 7, PAM with atypia/melanoma in 2 and CIN versus an atypical epithelioid type melanocytic lesion in 1 case. IC results were consistent with the clinical diagnoses in 9 cases (Cohen's kappa index of 0.83) and excluded CIN in 1. Histopathology in 6 cases disclosed benign melanonevus in 3, malignant melanoma in the context of PAM with atypia in 2, and CIN in 1 case. Histologic results were well correlated with the IC features (Cohen's kappa index of 0.74).
By demonstrating typical cytomorphological features of ocular superficial layers IC diagnosed the true nature of melanocytic ocular surface lesions in the majority of cases. Although IC does not substitute histopathology, given the high correlation between IC results and histopathology, it can be of great assistance in diagnosis and management of ocular surface melanocytic lesions.
报告临床诊断的眼表黑素细胞性病变的印片细胞学（IC）结果。
10例临床诊断为眼表黑素细胞性病变的患者使用醋酸纤维素条进行IC检查，并采用过碘酸希夫-巴氏染色法。若IC检查发现非典型细胞或应患者要求，对病变进行切除活检，切除标本进行组织病理学分析。评估临床诊断与IC结果之间以及IC结果与组织病理学之间的一致性。
临床诊断为痣6例，原发性获得性黑素沉着症（PAM）伴非典型性/黑素瘤2例，非典型痣与色素性结膜上皮内瘤变（CIN）2例。IC结果提示良性痣7例，PAM伴非典型性/黑素瘤2例，CIN与非典型上皮样型黑素细胞性病变1例。IC结果与临床诊断在9例中一致（科恩kappa指数为0.83），排除CIN 1例。6例组织病理学检查显示3例为良性黑素痣，2例为PAM伴非典型性背景下的恶性黑素瘤，1例为CIN。组织学结果与IC特征高度相关（科恩kappa指数为0.74）。
通过显示眼表浅层典型的细胞形态学特征，IC在大多数情况下诊断出黑素细胞性眼表病变的真实性质。虽然IC不能替代组织病理学，但鉴于IC结果与组织病理学之间的高度相关性，它在眼表黑素细胞性病变的诊断和管理中可提供很大帮助。
